[Clinical features and treatment outcomes of peripheral T-cell lymphoma, unspecified: a report of 78 cases].

Objective To summarize the clinical features and treatment outcomes of peripheral T- cell lymphoma,unspecified(PTCL-US).Methods The medical records of 78 patients with PTCL-US classified according to the revised European and American lymphoma(REAL)or WHO criteria,58 males and 20 females,aged 39(9-75),46 of them(59%)being at the stages Ⅲ/Ⅵ and 40 cases(51.2%) with extranodal involvement),treated from Jan 1994 to Dec 2004 in the Cancer Hospital/Institute,Chinese Academy of Medical Sciences,were retrospectively analyzed.The patients were followed up for 58 months. Results Thirty patients(38%)were with high level lactate dehydrogenase(LDH).34 cases(43.7%) were treated with ehemoradiotherapy,and 43(55 %)with chemotherapy alone.After the first line treatment the complete recovery(CR)rate and partial recovery(PR)rate were 55.1%(43/78)and 25.6%(20/ 78)respectively.15 cases(19.2%)showed progressive disease(PD)or stable disease(SD).Achieving CR or PR after first-line treatment,13 cases received autologous peripheral blood stem cell transplantation (APBSCT).The 5-year overall survival rate(OS)and 5-year progressive-free survival rate(PFS)were 41.4% and 33.8% respectively.The 5-year OS of the CR,PR,and PD/SD groups were 65.1%,21.9%, and 0% respectively.The 5-year OS for the patients treated with first-line APBSCT was 61.5%,not significantly different from that of the patients treated with conventional dose therapy alone(52.3%,P= 0.894).Univariate analysis showed that the factors associated with a worse OS included stage Ⅲ/Ⅳ(P= 0.001),high LDH(P=0.0001),behavior state score≥2(P=0.001),and bone marrow involvement (P=0.011).Multivariate analysis showed that LDH level was an independent factor predictive of survival (P=0.001).International prognostic index and prognostic index for peripheral T-cell lymphoma both predicted the overall survival.Conclusion A rare lymphoma with aggressive presentation,PTCL-US responds poorly to conventional treatment.The prognosis of the cases with high risk is bad.APBSCT is safe and feasible when CR or PR is achieved after first line treatment.